Anxiety | The connections between Art and Neuropsychology

At first glance, the psychologist and the writer make unlikely bedfellows: the bohemian creative versus the silent sage. If the task of the psychologist is to study, assess, and treat problems affecting the human mind, then the writer must put form on the human experience, and capture its essence. Through the ages, writers and poets have captured the many facets of anxiety. In Macbeth, Shakespeare wrote about the physical aspects of anxiety and how it can make ‘my seated heart knock at my ribs’. Franz Kafka described his own anxiety as “the feeling of having, in the middle of my body, a ball of wool that quickly winds itself up, its innumerable threads pulling from the surface of my body to itself.” Poet Ann Sexton described the interiority of anxiety: ‘Quite collected at cocktail parties, meanwhile, in my head, I’m undergoing open-heart surgery’.

Shakespeare depicted intense anxiety in through the character of Macbeth.

Plays, novels, poems… centuries of writers have given shape to the universal experience of anxiety. The field of neuropsychology adds another layer to our knowledge; the pounding heart that Shakespeare alludes to as well as the other physical symptoms of anxiety is driven by activation of our internal alarm – the sympathetic nervous system (SNS). The hypothalamus, the pea-sized control centre deep in the brain, starts off a chain of reactions: chemicals adrenaline, noradrenaline and cortisol are released into the bloodstream sending messages around the body. The heart speeds up, directing blood to the limbs, which require extra energy for fleeing or fighting, breathing quickens to get more oxygen into the body, and blood is diverted from non-essential functions like digestion which can cause the upset-stomach feeling.

This internal alarm system also prepares us psychologically for fight or flight and moves us into attack mode; attention becomes focused on short-term survival. Like airport security during a terrorist threat, we see the world through the filter of possible danger and it can be difficult to focus on anything that is not related to the threat.

The human mind and body is a very well designed, highly sensitive, and fast acting threat- detection machine, primed to be alert to danger. Our brain developed in a different environment to the one in which we now live. When our ancestors were roaming the savanna, hunting for food and trying to avoid being eaten by predators, it was this internal alarm system that helped to ensure their survival. On hearing a rustle in the bushes, better to be ready to flee or fight rather than stopping to deliberate on whether this really was a sabre-toothed tiger or just the wind. Act fast and you might live to see another day, fail to act and you might be eaten.

Anxiety, despite feeling uncomfortable or even distressing, is a normal reaction to feeling threatened. The problem is that modern threats are very different in nature. We may not have to worry about predators but we still have the same brains, the same hardware with which we experience our world. Thanks to the powers of imagination, worrying (the cognitive or thinking part of anxiety) can focus on a variety of threats from the momentous to the mundane. The Monty Python song ‘I’m so worried’ skewers the wide-ranging nature of anxiety, listing worries from the baggage retrieval system at Heathrow, to shows on TV, to modern technology.

There is no end to possible worries, and these imagined threats can be sufficient to activate the alarm system in the brain; except, unlike the sabre-toothed tiger, we can’t run away from the makings of our own mind. If we have to live with this inner alarm system (and we do) then we need to become attuned to what sets it off and the role our mind plays in keeping the alarm sounding. So while we might share in Macbeth’s thoughts that “present fears are less than horrible imaginings”, having the tools to identify and unstitch the two can help us to manage both.

Dr Su Yin Yap is a Clinical Psychologist and Psycho-sexologist (which is a Real Thing). She works in the NHS and runs her own private practice in London. She is involved in teaching, individual therapy and runs Mindfulness courses for the public and private sector. She has a particular interest in taking psychology out of the clinic room and using psychological research and techniques to help people thrive. www.mindsurgerylondon.co.uk

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